T Nation

Low T, I Think It's Thyroid? Ksman (was on Clomid now t-cyp)

Well I started with hot flashes, during them blood pressure would go up to 145/100. Could not sleep, had them almost all day. started around 10/8. Here are my labs. Please help in what you think it is. Its confusing - i dont know what is a symptom or the cause.

RANGES TSH .27-4.2 t3 76-81 FSH 1.5-12.4 LH 1.7-8.6 pro 4.1-18.4 est 11-43 males t 264-916

9/23/2016 (last year while i was “normal” lol) TSH 1.38 t4 1.2 t3 97
10/8/17 TSH 2.0 t4 1.3 t3 85 test 434
10/16/17 TSH 1.9 test 200 (in the pm)
10/21/17 test - 227 (in the am)
10/24/17 TSH 3.25 (did not do full thy profile), FSH 5.6 LH 3.3 Prolactin 14.4 estradiol 15
updated 10/27 - got back test for 10/24 draw test free 10 (range 6.8-21.5) test 379 (264-916)

Thank you.
I still presently get hot flashes but they are much better.

We need more information. Medications? are you on TRT? Prior use? I have taken an estrogen blocker (otc) before that gave me hot flashes. Give us more to go off of.

I am 40 yo. on no medications, never on TRT or any substances.
This seems so acute to me. I thought maybe it started with a stressful event late sept/early oct. But that stress has been eliminated. I do have ED symptoms too. Erections not hard , low libido.

Never had hot flashes before. Makes sense though with the sudden drop in T.
Just looking to get more informed for when I speak with MDs.
I personally think my low end t3 and high end TSH (not sure why so sudden though) = hypothyroidism. My dad has it.

And am thinking if I fix my thyroid, will increase T back to where it was (probably over the 434 reading i got when first tested - always was super horny lol)

I predict may be difficult to get dx of hypothy since numbers are “within” range. ALso would like to know if it is good to treat with TRT and hypothy at the same time.

Thank you.

BTW all liver functions, cbc, metabolic panel are ok. I will update my main post with ranges.

Your pituitary gland is producing FSH (and my inference) LH at a proper level. Yet you have low total testosterone. You may have low SHBG (which means free test would be well and good) or you have primary hypogonadism. Though with the labs you provided no suggestion of potential diagnosis can be made. Please get the full range of labs posted in the stickies.

Also just stating your labs are “OK” does not tell the story. Please post all labs and ranges and request any you are missing that are recommended in the stickies

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imaged labs from 10/8, and one from 10/24 labeled
addition to main post:
Vit D25 20.2 range 30-80
Trigly 305
Chol 178
HDL 41
LDL 76
PSA .56

Aldosterone 3.3 range 0-30
Cortisol at 2:50pm 12.7 range 2.9-17.3
Iron 115 range 65-175
TIBC 439 range 250-450
Iron sat 26% range 20-50
UIBC 324 ug/dL
I also have fatty liver disease for decades. Mild.
Thank you for your time.

also, I have a urologist that specializes in fertility and sexual health (not trying to conceive , have 3 kids - am done with that department). But went to him because appears to know about male hormones. He ran those tests from 10/24. But i asked him to take the full thyroid profile and he said no need to. So thats why i only have TSH for 10/24. He should have taken the full profile. Tells me he has limitations with thyroid stuff.
So i really dont want to confuse matters, as I think the urologist more likely to prescribe TRT if necessary, but I made an appt with my primary dr who is also a nephrologist. Because I really want the thyroid further investigated since i suspect hypothr. I just think there is something to my increase TSH #s even though still within range. And t3 #s are in the low normal range.
Then am thinking if they give me t4 medication, my dad takes synthroid, would that help make t3 since my t4 appear normal in range.

ANy thoughts on my course of action would also be appreciated.

Thanks again.

Also scrotum u/s done yesterday with Doppler, all good. also did u/s of area between scrotum and rectum. all functioning and good. testes normal size. no varicocele. blood flow fine.

Bump and updated with t #s in main post. Thanks.

any opinion guys?

Your thyroid seems fine. Ideal is closer to 1.0 for TSH (refer to KSman’s sticky for thyroid basics). Total test is on the low side. Free Test and SHBG tests would assist is certainly preferred to have for baseline prior to any TRT. Also an E2 sensitive test (LCMS) for baseline would be great. If your E2 is fine currently (mid 20’s ish) but T is low you know E is going to be a problem if you go on TRT. You have already mentioned hot flashes and the sort which implies low E. With T low, a lower E2 level would also be indicated. Without a SHBG test it can not be scene by inference however.

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@grungephreak Thank you so much for looking.
the estradiol was 15 (range 11-43 for males) on 10/24
Interesting how the t is going back up on its own was 379 on 10/24 free T was 10 (6.8-21.5).
SHBG on 10/26 was 18 (10-50) Cortisol at 11am on 10/26 was 16.8 (4-22 am)
other new stuff that came in : 10/26 TSH going back towards my norm level was 1.77
10/26 T3 total 75 (76-181)
t3 free 3.1 (2.3-4.2)
t4 free 1.2 (.8-1.8)
t3 reverse 16 (8-25)
I dont understand why total t3 is low when free t3 seems fine.
I just feel that perhaps this period of my T droping was because of severe stress (which has been alleviated) and now the #s are going back to normal.
Doc gave me viagra - i f’d like a bunny last night :slight_smile:
Just needed the extra stuff to keep it hard.

Stress is a killer of T levels. Good luck to you

Went to endo. Gave me choice of TRT, i picked axiron. I dont think it was a good choice now that am home. He is willing to change it, as i asked while in his office just in case. He dx secondary hypogonadism. wants to run blood work 3 months after axiron.

Sending me for MRI pf pituitary and u/s thyroid (felt nodule).

Still have ED symptoms, though better. and get hot flashes easily when nervous/stressed.
I dont think i want to start TRT, would like to see if T is continuing its incline.

@grungephreak Dr also gave option of clomid?

ANy advice please? Thank you.

I would call a total T of 227 to be insanely low, you’ve already declined enough. Too many diseases at those levels, gels produce too many sides effects and typically poor absorption! The drug companies love making money though.

would you suggest clomid? BTW T level was up to 379 on 10/27.
Yeah i think when the dr so the 200 and 227 reading, like you, he wanted me to get relief.

Am thinking to get a T/Tfree reading a day this week in the am, if its over 500, and I have no impotence issues - i am good with that. I will get the test ordered by a diff doctor in case I still want the TRT or clomid.

Clomid might work if you are under 30 years old, but rarely do I ever hear of success stories.

Can someone share the link to the clomid sticky? I can not seem to find it.

Thank you.